Can you buy health insurance out of state?

I'm hoping somebody familiar with the insurance industry (101A?) could answer this one for me.

Basically, we reside in NJ, but the specialists my wife sees are in PA (45 min ride from here). She is likely to lose her job soon due to a (hopefully temporary) disability, and under the FMLA, her insurance coverage ends at the end of October. We both used to be insured under her job's group plan.

Now, under NJ insurance laws, premiums are all the same regardless of age or health condition, which puts insurance for the two of us at about $1,700/mo, and that's without including the fairly high deductibles. Crazy, and we just can't afford that.

On the other hand, PA insurance doesn't have the same premium limitations as in NJ, and thus it's much more affordable (about $450/mo for the two of us). We're both in our late 30's, no smoking.

Could we buy insurance in PA even though we reside in NJ? I wouldn't mind having to drive to see PA doctors. Or you have to reside on the state?

Actually, after looking up some more, I guess the answer is no. Still, if somebody has more info, please chip in.

EN,

Well, you found it, you cannot buy insurance across state lines, and in trying to do a good thing to help out the tough to insure; NJ has made the prices for everybody very high, indeed. (I believe they also have a very "rich" mandated benefit package; driving the price up even higher).

You should ask your wife to find out how much COBRA premiums will be for both her individually, and you as a couple - or if she is retaining her job, if she can continue on the group benefit plan, if you pay the full premium. Of course, chances are, that is not going to be significantly more attractive. Unfortunately for you, PPACA will, to a large degree help mitigate the costs for you - but not until '14.

Situation sucks. Employer funded health insurance has inherent problems.

Ummm the GOP have been proposing allowing this for as long as I can remember. Your side thinks it's a crazy idea.

My wife and I are about 10 years older than you, I smoke, and we pay $335 a month for health insurance here in Texas.

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Originally Posted by SnakeBoy

Ummm the GOP have been proposing allowing this for as long as I can remember. Your side thinks it's a crazy idea.

My wife and I are about 10 years older than you, I smoke, and we pay $335 a month for health insurance here in Texas.

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I have no idea what you are talking about, and if you are a 53 year old smoker, you aren't paying $335 for insurance anywhere - in fact, you're damn near uninsurable. You're not a risk, you're a claim.

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Originally Posted by 101A

I have no idea what you are talking about,

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Seriously you have never heard republicans talk about this? It's on the GOP website.

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Purchase Health Insurance across State Lines
Americans residing in a state with expensive health insurance plans are locked into those plans and do not currently have an opportunity to choose a lower cost option that best meets their needs. We will allow individuals to buy health care coverage outside of the state in which they live.
http://www.gop.gov/pledge/healthcare

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Originally Posted by 101A

and if you are a 53 year old smoker, you aren't paying $335 for insurance anywhere

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Where did you get 53? I'm 45, he said he's late 30's and I said about 10 years older. And we pay $335 a month with Blue Cross/Blue Shield...it's true whether you want to believe it or not.

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Originally Posted by SnakeBoy

Seriously you have never heard republicans talk about this? It's on the GOP website.





Where did you get 53? I'm 45, he said he's late 30's and I said about 10 years older. And we pay $335 a month with Blue Cross/Blue Shield...it's true whether you want to believe it or not.

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Sure I know its a point - and it's been addressed, however, Nono wasn't making a political point; just asking for advise; you decided to tribe up on the topic; should of been more clear about why I was perplexed by your post. Thought you were responding to me, and somehow remembered my age from a previous discussion.

Stop smoking. HUGE difference between 45 and 53, btw. 15 years from now? You're practically on borrowed time. Seriously stupid, bro. Stop.

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Originally Posted by 101A

EN,

Well, you found it, you cannot buy insurance across state lines, and in trying to do a good thing to help out the tough to insure; NJ has made the prices for everybody very high, indeed. (I believe they also have a very "rich" mandated benefit package; driving the price up even higher).

You should ask your wife to find out how much COBRA premiums will be for both her individually, and you as a couple - or if she is retaining her job, if she can continue on the group benefit plan, if you pay the full premium. Of course, chances are, that is not going to be significantly more attractive. Unfortunately for you, PPACA will, to a large degree help mitigate the costs for you - but not until '14.

Situation sucks. Employer funded health insurance has inherent problems.

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Thanks for heads up. I'll ask her to find out about COBRA. The type of insurance used in her job was self-insured, so I hope there's no problem with that and COBRA.

Basically, I'm more concerned with her situation at this point than the insurance, and even if her surgery goes ok next week, she'll lose her job and insurance anyways (DSEK surgery on her only good eye, 2-3 months recovery time). COBRA sounds like the ticket going forward. I believe she used to get $70 taken off her paycheck for insurance, so the premium would be $140, right?

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Originally Posted by ElNono

Thanks for heads up. I'll ask her to find out about COBRA. The type of insurance used in her job was self-insured, so I hope there's no problem with that and COBRA.

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Self insured (ERISA) plans are absolutely subject to COBRA - however there is a difference in how COBRA premiums are calculated. This can work for, or against you. In a fully insured plan, COBRA premiums are set 2% above premium cost; in a self-funded plan, they are set actuarially based on the actual cost to the plan of a given unit (employee or spouse in this case).

Note: MANY companies skimp on this step, and don't actually pay an actuary to determine their rates; if the rates are excessive, ASK to see the actuarial calculations, or report, that determined them. If they cannot produce this, call the DOL (regulates ERISA plans) - or at least threaten to, the fines are beyond severe for screwing around with this.

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Originally Posted by SnakeBoy

Ummm the GOP have been proposing allowing this for as long as I can remember. Your side thinks it's a crazy idea.

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My side does? Not me.

I personally would rather have single payor from a price-control perspective, but since that's off the table, I would take cross-state insurance any time of the day.

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Originally Posted by 101A

Self insured (ERISA) plans are absolutely subject to COBRA - however there is a difference in how COBRA premiums are calculated. This can work for, or against you. In a fully insured plan, COBRA premiums are set 2% above premium cost; in a self-funded plan, they are set actuarially based on the actual cost to the plan of a given unit (employee or spouse in this case).

Note: MANY companies skimp on this step, and don't actually pay an actuary to determine their rates; if the rates are excessive, ASK to see the actuarial calculations, or report, that determined them. If they cannot produce this, call the DOL (regulates ERISA plans) - or at least threaten to, the fines are beyond severe for screwing around with this.

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Good info. Many thanks!

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Originally Posted by ElNono

Basically, I'm more concerned with her situation at this point than the insurance, and even if her surgery goes ok next week, she'll lose her job and insurance anyways (DSEK surgery on her only good eye, 2-3 months recovery time). COBRA sounds like the ticket going forward. I believe she used to get $70 taken off her paycheck for insurance, so the premium would be $140, right?

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Im afraid not. Were talking actual cost not just what is charged to emplyees. There are other nuances to consider - got to crash. Ill PM you tomorrow to discuss further.

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Originally Posted by 101A

Im afraid not. Were talking actual cost not just what is charged to emplyees. There are other nuances to consider - got to crash. Ill PM you tomorrow to discuss further.

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I see. No problem. I'll have her call her job and ask. They'll probably be able to find out what the rates are. Thanks for the good info :tu

Looks like after 6 months without insurance she would qualify for PCIP (NJ Protect here in Jersey). I'll see if I can find out more too.

"Employer funded health insurance has inherent problems."

... to the benefit of the employers and insurance companies.

COBRA sucks because you have to pay 100% of the premiums yourself, without being able to deduct any of it from taxable income, like a Corporate-American can. I know one medical-condition lady who tried to do COBRA (she couldn't afford it) but reduce her premiums by converting it to high deductible. "Fnck you, lady. No premium reductions"

Same for self-employed. Pay 100%, nothing deductible from taxes.

The tax code certainly discourages entrepreneurial self-employment and the Human-American. It's all rigged to screw them and prefer the Corporate-Americans. Why don't the tea baggers take up that issue?

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Originally Posted by SnakeBoy

I'm 45, he said he's late 30's and I said about 10 years older. And we pay $335 a month with Blue Cross/Blue Shield...it's true whether you want to believe it or not.

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And what is your deductible. I pay over $200/month for a $5000 deductible policy through BC/BS and I am a female non-smoker, and it is only for me. This policy has never paid out a penny but it is there for an emergency.

"it is there for an emergency."

The industry term is "catastrophe insurance", usually with $3K or $5K deductible.

Cobra is going to be incredibly expensive but its probably your best option at this point because your wife is going to have a preexisting condition so getting new insurance is going to be pretty much impossible. I'm not sure where you got your quote from, but I doubt they would even insure you depending on your wife's condition. If they will insure you, it will likely be for everything BUT what you're getting covered for.

Where did you get that quote if you don't mind me asking? My license lapsed nearly a decade ago so I have no real current info but 101 is providing you with solid advice. Otherwise, your best bet will be to talk to several insurance agents to see what they can do for you. Definitely find out about Cobra or about getting insurance through your employer if possible.

There are a few websites, google "pre-existing condition health insurance".

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Originally Posted by ploto

And what is your deductible. I pay over $200/month for a $5000 deductible policy through BC/BS and I am a female non-smoker, and it is only for me. This policy has never paid out a penny but it is there for an emergency.

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Hmmm, Is this one of their healthcare savings plans? We've had this plan a long time and I honestly don't remember all the details off hand. I think we have the Select Saver plan with a $2500 deductible. It pays most of the routine care costs, plus rx benefits, etc. Details here...
http://www.bcbstx.com/coverage/indiv...s4compare.html

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Originally Posted by 101A

Stop smoking. HUGE difference between 45 and 53, btw. 15 years from now? You're practically on borrowed time. Seriously stupid, bro. Stop.

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No need to lecture, I know it's stupid. I quit smoking regulary on my 40th birthday. I now allow myself to enjoy some smokes one day every other weekend plus when when we're on vacation. I stick to that strictly so I don't get hooked again. I promised my wife I would quit completely on my 46th birthday...I'll miss it though.

Where's the outrage against Corporate-Americans and sick-care providers who've limited access to insurance AND raised costs so high to be out reach, to be impoverishing for middle Americans and self-employed.

Americans are bunch of indoctrinated sheeple, indoctrinated with the idea that Corporate-Americans are beyond reproach, are the highest form of human activity, never guilty of anything, and are anyway beyond any chance of stopping their predations.

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Originally Posted by boutons_deux

Where's the outrage against Corporate-Americans and sick-care providers who've limited access to insurance AND raised costs so high to be out reach, to be impoverishing for middle Americans and self-employed.

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I think you've monopolized it all.

http://finder.healthcare.gov/

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Originally Posted by boutons_deux

Americans are bunch of indoctrinated sheeple, indoctrinated with the idea that Corporate-Americans are beyond reproach, are the highest form of human activity, never guilty of anything, and are anyway beyond any chance of stopping their predations.

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Where do you get this? "CEO" is just below "Crack Whore", and just above Congressman in the most reviled professions list.

CEO is a Human-American, and almost none of them go to jail, or lose their jobs or even their bonuses when a CEO's Corporate-American screws up badly, or commits crime. The C-A "settles" for a handslap, the CEO counts his untouched compensation.

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Originally Posted by MannyIsGod

Cobra is going to be incredibly expensive but its probably your best option at this point because your wife is going to have a preexisting condition so getting new insurance is going to be pretty much impossible. I'm not sure where you got your quote from, but I doubt they would even insure you depending on your wife's condition. If they will insure you, it will likely be for everything BUT what you're getting covered for.

Where did you get that quote if you don't mind me asking? My license lapsed nearly a decade ago so I have no real current info but 101 is providing you with solid advice. Otherwise, your best bet will be to talk to several insurance agents to see what they can do for you. Definitely find out about Cobra or about getting insurance through your employer if possible.

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I just did a cursory rate lookup in ehealthinsurance.com (run by Aethna, IIRC).

Ideally, we'd like to both be covered, so COBRA definitely sounds like a tempting option (we'll see what the rate is). If not, then we'll probably have to wait 6 months and go for PCIP just for my wife (unless she recovers and can find a job by then).

I'm part-owner now, so I'm basically self-employed. Which means the cost of getting insurance for me through work (Small Business health insurance) is basically the same as an individual plan, and we really can't afford it.

Thanks Manny.

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Originally Posted by SnakeBoy

No need to lecture, I know it's stupid. I quit smoking regulary on my 40th birthday. I now allow myself to enjoy some smokes one day every other weekend plus when when we're on vacation. I stick to that strictly so I don't get hooked again. I promised my wife I would quit completely on my 46th birthday...I'll miss it though.

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Switch to e-cigs. You get the nicotine hit, get to go on with the smoking mannerisms, but none of the tar or cancerogenous chemicals.

Cheaper too!

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Originally Posted by ElNono

Switch to e-cigs. You get the nicotine hit, get to go on with the smoking mannerisms, but none of the tar or cancerogenous chemicals.

Cheaper too!

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I bought one to try but it didn't do much for me. I don't get nicotine cravings anymore. Just enjoy occasionally hanging out with friends drinking beer and smoking.

I've accepted that as I age I will be giving up things I enjoy. First smoking then someday drinking then maybe sex etc. I figure when those things are gone and mexican food is too spicy for me and I think Luby's cafeteria food has flavor it's time to just die.

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Originally Posted by SnakeBoy

I bought one to try but it didn't do much for me. I don't get nicotine cravings anymore. Just enjoy occasionally hanging out with friends drinking beer and smoking.

I've accepted that as I age I will be giving up things I enjoy. First smoking then someday drinking then maybe sex etc. I figure when those things are gone and mexican food is too spicy for me and I think Luby's cafeteria food has flavor it's time to just die.

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Worked for me, after plenty of looking around and trying different models. Oh well. If anybody is interested in some recommendations, just ask.

"mexican food is too spicy"

The spices in MX and other peasant foods around the world are actually very healthy, anti-inflammtory and anti-cancer.

What's unhealthy about (Tex) MX food is the lard, the meat, the corn, the flour, the cheeses, the rice. iow, unhealthy fats and high carbs.